| NPI | 1619026077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY MIDDLEDITCH Obra Specialist 810-762-5230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 4704181048) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |